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Objective To evaluate the relationship between modified Frailty Index(mFI)and de-velopment of delirium after artificial joint replacement in elderly patients.Methods Elderly patients(aged≥60 yr)who scheduled for elective hip or knee replacement,were enrolled.Preoperative frailty was assessed using the mFI scale.All the patients received surgery under combined spinal-epidural anesthesia.Primary outcome was the incidence of delirium within 5 days after operation,and delirium was assessed by Confusion Assessment Method or Confusion Assessment Method-Intensive Care Unit.The patients were di-vided into delirium group and non-delirium group according to whether delirium occurred or not.Results A total of 620 patients were included in the study,the mFI was 0.09(0.18),and the incidence of delirium within 5 days after surgery was 8.5％.The results of multivariate logistic regression analyses showed that in-crease in age(OR 1.068,95％CI 1.018-1.120,P＝0.007),higher postoperative consumption of mor-phine(OR 1.089,95％CI 1.051-1.128,P＜0.01)and higher mFI(OR 2.465,95％CI 1.636-3.714,P＜0.01)were the independent risk factors for postoperative delirium.Conclusion Higher mFI is the independent risk factor for delirium after artificial joint replacement in elderly patients.
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Objective@#To evaluate the relationship between modified Frailty Index (mFI) and development of delirium after artificial joint replacement in elderly patients.@*Methods@#Elderly patients (aged ≥60 yr) who scheduled for elective hip or knee replacement, were enrolled.Preoperative frailty was assessed using the mFI scale.All the patients received surgery under combined spinal-epidural anesthesia.Primary outcome was the incidence of delirium within 5 days after operation, and delirium was assessed by Confusion Assessment Method or Confusion Assessment Method-Intensive Care Unit.The patients were divided into delirium group and non-delirium group according to whether delirium occurred or not.@*Results@#A total of 620 patients were included in the study, the mFI was 0.09 (0.18), and the incidence of delirium within 5 days after surgery was 8.5%.The results of multivariate logistic regression analyses showed that increase in age (OR 1.068, 95% CI 1.018-1.120, P=0.007), higher postoperative consumption of morphine (OR 1.089, 95% CI 1.051-1.128, P<0.01) and higher mFI (OR 2.465, 95% CI 1.636-3.714, P<0.01) were the independent risk factors for postoperative delirium.@*Conclusion@#Higher mFI is the independent risk factor for delirium after artificial joint replacement in elderly patients.
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Objective To evaluate the effect of early postoperative delirium on prognosis in the pa-tients undergoing coronary artery bypass graft in a nested case control study. Methods A total of 308 pa-tients scheduled for elective coronary artery bypass graft were divided into delirium group or non-delirium group according to whether early postoperative delirium occurred. Type of surgery (on-pump or off-pump) and difference of EuroSCORE between two cases ≤2 were considered as criteria, and patients in two groups were matched with a ratio of 1 : 1. The development of complications was observed within 28 days after op-eration. The development of complications developed after delirium was recorded in delirium group. Results The incidence of delirium was 46. 4％. The total incidence of complications, postoperative cardiac insuf-ficiency and incidence of arrhythmia were significantly higher in delirium group than in non-delirium group (P<0. 05). Conclusion Early postoperative delirium is not helpful for the prognosis in the patients under-going coronary artery bypass graft.
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Objective To evaluate the effect of early postoperative delirium on outcomes in elderly patients undergoing joint replacement.Methods Elderly patients,aged ≥ 60 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective hip or knee joint replacement,were divided into delirium group and non-delirium group according to whether the patients developed postoperative delirium.The case-matching criteria was set up with difference in age less than 5 yr and difference in Charlson comorbidity index less than 2 and with a ratio of 1 ∶ 4 for match.The development of complications was recorded within 28 days after operation.Complications happened after delirium was recorded in delirium group.Results There were 53 cases in delirium group and 212 cases in non-delirium group.There was no significant difference in preoperative baseline data or intraoperative variables between two groups (P ＞0.05).Compared with non-delirium group,the total incidence of postoperative complications was significantly increased,the incidence of postoperative cognitive dysfunction,cardiovascular complications,pulmonary complications and deep venous thrombosis was increased,and the length of hospitalization was prolonged in delirium group (P＜0.05).Conclusion Early postoperative delirium is not helpful for outcomes in elderly patients undergoing joint replacement.
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Objective To discuss the correlation between female chronic pelvic pain and pelvic floor anatomy.Methods The female patiems of chronic pelvic pain 179 cases,age 28-67 years,average 49.4 years;pelvic pain history 8 months-9 years,average 2.8 years;167 cases has childbirth history,43 cases has surgery history,which gynecological surgery 31 cases,and urinary surgery 7 cases,and anus surgery 5 cases.Results High incidence of female pelvic pain were 30-60 age (incidence of 54.8％),93.3％ has birth history,24％ has operation history,the myofascial tissue pain higher than the organ,were 87.4％ than 12.6％ (P ＜ 0.01),the front of pelvic pain higher than back,were 65.6％ than 21.8％ (P ＜ 0.01).Conclusions Female chronic pelvic pain associated with the particularity of the pelvic anatomy and physiological,with the tissue of pelvic floor and urogenital diaphragm of primary injure and chronic inflammation is an important cause of chronic pelvic pain.
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Objective To analyze the risk factors of urolithiasis in pregnancy and the relationship between urolithiasis in pregnancy and pregnancy outcomes.Methods From January 2004 to December 2009,the clinical data of 162 pregnant women (Group A),diagnosed as upper urinary tract calculi,were reviewed,retrospectively.Their age ranged from 18 to 41 years (mean 24±5 years).Seven of them had history of urolithiasis before pregnant.At the same time,150 pregnant women without urinary stone (Group B) were also included in this study,whose mean age was 23±5 years.In addition,150 women without pregnant and urinary stone (Group C) were included in this study,whose mean age was 24±4 years.The blood and urine routine results,blood uric acid and electrolytes were recorded and compared among those groups.In group A,119 cases had symptomatic urolithiasis.Surgical intervention was performed in 24 cases and the conservative therapy was performed in 95 cases.The rates of abortion,premature delivery and cesarean delivery were compared between two groups.Results Compared group A with group B and group C,there were significant differences in the urine WBC (145.16±202.18 vs.46.00± 119.50 and 55.33 ± 145.36 per high power lens) and urine ketone body (2.41 ± 6.14 mmol/L vs.0.30± 1.75 mmol/L and 0.17± 1.26 mmol/L) (P＜0.05).Meanwhile,there were significant differences in the blood leukocytes [(11.39±3.89)× 109/L,(10.78±2.98) ×109/L vs.(6.21±1.48) × 109/L],the blood uric acid (331.12±215.22 μmol/L,329.32± 88.50 μmol/L vs.280.01±69.88 μmol/L),the urine protein (0.29±2.00 mmol/L,0.10±0.19 mmol/L vs.0.02±0.09 mmol/L),urine glucose (2.50±8.44 mmoL/L,2.35±8.63 mmol/L vs.0.25± 1.97 mmol/L) and urine erythrocyte (76.60±98.11,77.43±71.00 vs.13.77±37.93 per high power lens) (P＜0.05).In those patients with symptomatic urolithiasis,there was 1 case of abortion in the conservative treatment and surgery intervention groups,respectively.The premature delivery rate and cesarean delivery rate were 5.3％ vs.0％ and 17.9％ vs.4.2％,respectively.Conclusions The blood leukocytes,blood uric acid,urine protein,urine glucose and urine erythrocytes are significantly high in pregnant women than those in non-pregnant women.However,the relationship between those abnormality and urolithiasis in pregnancy is still indefinite.Since the urine leukocytes and ketone increase obviously,it might suggest that the occurrence of the urine calculi is related with the metabolism of nourishment and electrolytes,urinary tract infection in pregnancy.The surgery intervention may be a risk of fetus miscarriage.
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Objective To evaluate the examination of non-small-cell lung (NSCLC) vein formation and the dynamic characteristics of blood stream through enforced SCT scanning for the research on and clinical diagnosis of tumor.Methods Double period enhanced SCT scanning was done to 152 NSCLC cases identified pathologically.Makes the color coding the tumour blood stream irrigation chart,the analysis blood stream irrigation characteristic.Compare the enforced morphologic manifestation of cancer focus with histology and analyze their pertinence.Results The enforced CT peak value (PV) of the low differentiation is bigger than that of the medium differentiation,which is bigger than the high differentiation.63 cases are 45-70 HU,78 cases are 20-45 HU and 11 cases are 10-20 HU.67 case are of abnormal arteriola; 23 cases are of abnormal hemal sinus development; 35 cases are pistil-like.Conclusion Accurately examining and quantifying cancer focus vein formation according to SCT double period enforced scanning is of high guiding value in the enactment of the plan for treating NSCLC and the comprehensive treatment of tumors.